Critical planning and precision: the key to successful air ambulance transfers

Air medical transportation demands meticulous coordination to ensure the safe movement of patients across long distances. However, when missions take place in high-risk regions with complex security and logistical challenges, the hurdles become even more significant. This case study details the recent repatriation of a critically ill 65-year-old male patient from a high-risk area to Dubai, where both medical and logistical challenges were substantial.

The patient was found unconscious at home with limited medical information available at the time of the mission. He had presented with a fever and, upon regaining consciousness, displayed spontaneous eye opening but remained disoriented. The patient was on oxygen support, although no inotropes were required.

Preliminary investigations showed elevated total count (TC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), with a negative Covid-19 PCR test result. Given the minimal information available, the team had to plan for a worst-case scenario while ensuring that all medical and logistical aspects of the mission were meticulously addressed.

Pre-flight preparation

Transporting a patient from such a highrisk region posed numerous challenges. The complex security situation in the area required extensive coordination, including securing necessary permissions for aircraft landing and managing all communications with local authorities.

Ensuring the safety of both the patient and the medical crew was paramount.

Every aspect of the mission was meticulously managed, and contingency plans were put in place to address any potential risks that might arise.

With limited time to prepare, the team began organising the mission overnight for an emergency repatriation the next morning. Special considerations were made to address the possibility of neurological complications and any deterioration in the patient’s respiratory status during transport. The medical team planned for every possible scenario, ensuring that the patient’s condition could be stabilised if needed during the flight.

In-flight care

Upon arrival at the airport, the patient was brought by ambulance to the tarmac. He was found to be irritable and physically restrained due to difficulties in communication, primarily caused by the language barrier. After successfully securing a new intravenous access and conducting a thorough general and systemic examination, the patient was confirmed to be haemodynamically stable and cleared for transfer to the aircraft. Once effective communication was established and the medical crew understood the patient’s needs, the restraints were safely removed.

The transfer from the ambulance to the aircraft was executed using an automatic high-loader for the stretcher. Once aboard, the medical team conducted another general examination and confirmed the patient’s stability before advising the aircraft captain to proceed with take-off.

During the flight, the medical crew monitored the patient’s condition closely, using advanced life-support systems to ensure that the patient remained stable. Despite the high-stress environment and potential for unforeseen complications, the team’s experience in handling complex medical cases ensured a smooth and successful in-flight care process.

Outcome and conclusion

The mission was completed successfully, with the patient safely transported to Dubai. Upon arrival, he was offloaded into a ground ambulance and transported to a local hospital for further treatment. Despite the associated with the mission, the team’s precise planning and expert execution ensured the patient’s safe arrival and continued care.